重症监护病房病原菌流行情况及耐药性监测

Pathogens and drug resistance prevalence in intensive care unit

目的：了解重症监护病房（ICU）病原菌流行情况及主要细菌耐药性,为临床抗感染治疗提供依据。方法：应用回顾性调查方法,对2010年1~10月ICU患者送检的标本病原菌检验结果进行统计分析。结果：共分离出392株病原菌,其中醋酸不动杆菌检出率14.0%,金黄色葡萄球菌检出率13.5%,鲍曼不动杆菌检出率11.2%,肺炎克雷伯菌检出率9.18%,铜绿假单胞菌检出率7.14%。产超广谱β-内酰胺酶的大肠埃希菌检出率68.7%,产超广谱β-内酰胺酶的肺炎克雷伯菌检出率52.7%,耐甲氧西林金黄色葡萄球菌的检出率88.7%,耐甲氧西林凝固酶阴性葡萄球菌的检出率92.3%。未发现耐万古霉素、替考拉宁的金黄色葡萄球菌和凝固酶阴性葡萄球菌。结论：ICU流行的主要病原菌是醋酸不动杆菌、金黄色葡萄球菌、鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌;细菌耐药问题日趋严重。

Objective： To understand the intensive care unit（ICU） and the major bacterial pathogens resistant popular for clinical anti-infective therapy.Methods： By retrospective survey,the specimens for inspection from the ICU patients were analyzed from January 2010 to October 2010.Results： 392 pathogens were isolated,of which the detection rate of Acinetobacter acetate was 14.0%,Staphylococcus aureus was 13.5%,Acinetobacter baumannii was 11.2%,Klebsiella pneumoniae detection rate was 9.18%,7.14% detection rate of P.aeruginosa.Producing extended spectrum β-lactamase of Ecoli detection rate of 68.7%,producing extended spectrum β-lactamase Klebsiella pneumoniae detection rate of 52.7%,methicillin-resistant Staphylococcus aureus in the detection rate of 88.7%,resistance coagulase-negative staphylococci methicillin detection rate of 92.3%,no resistance to vancomycin and teicoplan in Staphylococcus aureus and coagulase negative staphylococci were found.Conclusion： In ICU acetate Acinetobacter,Staphylococcus aureus,Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae are the predominant pathogen,problem of bacterial resistance is increasing.